Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
Hand, Foot, and Mouth Disease (HFMD) is a prevalent childhood infectious disease caused by enteroviruses, posing significant public health concerns in China. This study aimed to provide information and evidence to guide public health response and intervention by exploring the trends of HFMD incidenc...
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Taylor & Francis Group
2025-12-01
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| Series: | Critical Public Health |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/09581596.2025.2503280 |
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| author | Fei Zhao Canya Fu Wenjie Xu Canjie Zheng Xiaoying Gong Quanjun Fang Chuanxi Fu Zhiying Yin |
| author_facet | Fei Zhao Canya Fu Wenjie Xu Canjie Zheng Xiaoying Gong Quanjun Fang Chuanxi Fu Zhiying Yin |
| author_sort | Fei Zhao |
| collection | DOAJ |
| description | Hand, Foot, and Mouth Disease (HFMD) is a prevalent childhood infectious disease caused by enteroviruses, posing significant public health concerns in China. This study aimed to provide information and evidence to guide public health response and intervention by exploring the trends of HFMD incidence among children under 10 years old in Quzhou from 2009 to 2023, and analyzing the influence of age, period, and cohort. Data on HFMD cases in Quzhou from 2009 to 2023 were collected and then analyzed using Joinpoint regression and age-period-cohort (APC) model to explore incidence trends and potential causes. A total of 75,284 HFMD cases were reported in Quzhou from 2009 to 2023, with children under 10 years old accounting for 99.01% of the cases. The main age group for onset was centered between 1 and 3 years. Before 2017, EV71 was the main pathogen in 3,360 laboratory-confirmed HFMD cases, followed by Cox A16. Since 2018, Cox A16 and Cox A6 have dominated. Serious cases have declined significantly since 2016. Joinpoint regression analysis showed two inflection points (2013 and 2021) with an up-down-up trend. The APC model indicated concentrated risk in children aged 1–3 years, with a periodic fluctuating trend of period effect and an overall increasing trend of cohort effect. The use of EV71 vaccine has temporarily reduced HFMD incidence, but the changing pathogen spectrum has led to a resurgence, highlighting the need to expedite the development and use of vaccines against Cox A strains to mitigate the impact of this disease. |
| format | Article |
| id | doaj-art-76ffc9a2c09e4459bf941f86a9648526 |
| institution | DOAJ |
| issn | 0958-1596 1469-3682 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Critical Public Health |
| spelling | doaj-art-76ffc9a2c09e4459bf941f86a96485262025-08-20T03:09:19ZengTaylor & Francis GroupCritical Public Health0958-15961469-36822025-12-0135110.1080/09581596.2025.2503280Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, ChinaFei Zhao0Canya Fu1Wenjie Xu2Canjie Zheng3Xiaoying Gong4Quanjun Fang5Chuanxi Fu6Zhiying Yin7Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaHand, Foot, and Mouth Disease (HFMD) is a prevalent childhood infectious disease caused by enteroviruses, posing significant public health concerns in China. This study aimed to provide information and evidence to guide public health response and intervention by exploring the trends of HFMD incidence among children under 10 years old in Quzhou from 2009 to 2023, and analyzing the influence of age, period, and cohort. Data on HFMD cases in Quzhou from 2009 to 2023 were collected and then analyzed using Joinpoint regression and age-period-cohort (APC) model to explore incidence trends and potential causes. A total of 75,284 HFMD cases were reported in Quzhou from 2009 to 2023, with children under 10 years old accounting for 99.01% of the cases. The main age group for onset was centered between 1 and 3 years. Before 2017, EV71 was the main pathogen in 3,360 laboratory-confirmed HFMD cases, followed by Cox A16. Since 2018, Cox A16 and Cox A6 have dominated. Serious cases have declined significantly since 2016. Joinpoint regression analysis showed two inflection points (2013 and 2021) with an up-down-up trend. The APC model indicated concentrated risk in children aged 1–3 years, with a periodic fluctuating trend of period effect and an overall increasing trend of cohort effect. The use of EV71 vaccine has temporarily reduced HFMD incidence, but the changing pathogen spectrum has led to a resurgence, highlighting the need to expedite the development and use of vaccines against Cox A strains to mitigate the impact of this disease.https://www.tandfonline.com/doi/10.1080/09581596.2025.2503280Hand, foot, and mouth diseasetrend analysisJoinpoint regression modelage–period–cohort model |
| spellingShingle | Fei Zhao Canya Fu Wenjie Xu Canjie Zheng Xiaoying Gong Quanjun Fang Chuanxi Fu Zhiying Yin Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China Critical Public Health Hand, foot, and mouth disease trend analysis Joinpoint regression model age–period–cohort model |
| title | Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China |
| title_full | Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China |
| title_fullStr | Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China |
| title_full_unstemmed | Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China |
| title_short | Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China |
| title_sort | trends and age period cohort effects on the incidence of hand foot and mouth disease among children younger than 10 years old from 2009 to 2023 in quzhou china |
| topic | Hand, foot, and mouth disease trend analysis Joinpoint regression model age–period–cohort model |
| url | https://www.tandfonline.com/doi/10.1080/09581596.2025.2503280 |
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